Understanding ICSI

ICSI (Intra-Cytoplasmic Sperm Injection) is a technique that was developed by the Infertility Center of Saint Louis in conjunction with the Brussels University to aide men with compromised sperm or low sperm counts in fertilising their partner’s or donor’s eggs for IVF. Unlike typical fertilisation in IVF which takes place in a dish, ICSI involves the use of a pipette to hold an egg, while a narrow needle immobilizes a single sperm, draws it up, and then injects it directly into the egg. Eggs fertilised in this manner, and determined to be of a specific quality, can then be transferred to the womb two to three days later.

ICSI technique and low sperm count in menAccording to an article published by Dr. Sherman J. Silber on the Infertility Center of Saint Louis website, “The fertilization rate per egg using ICSI is about 70% despite the sperm being terrible, the fertilization rate per infertile couple is over 99% if the wife has adequate eggs, and the pregnancy rate per treatment cycle is over 50%. This is not significantly different from regular IVF with normal sperm. This technique is very cost-effective, and will give you the same high chance for getting pregnant as any couple with normal sperm.”

Originally intended only to aide men with severe male factor infertility, a change in the industry’s view and understanding of the procedure over the last decade or so has resulted in an increase in the number of patients turning to ICSI, with some clinics using it on all of their cases.

So how well does it work? According to WebMD, when “used with in vitro fertilization and eggs of good quality, ICSI often is a successful treatment for men with impaired or no sperm in the ejaculate. ICSI (using sperm collected from the testicles) produces an estimated 25% to 30% birth rate. ICSI does not improve the chances of conception for men with good-quality sperm in the ejaculate.”